| NPI | 1649048810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 1520) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |